Journal
STATISTICS IN MEDICINE
Volume 29, Issue 7-8, Pages 885-895Publisher
WILEY
DOI: 10.1002/sim.3762
Keywords
relative survival; competing risks; crude mortality
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Funding
- MRC [MC_EX_G0800814] Funding Source: UKRI
- Medical Research Council [MC_EX_G0800814] Funding Source: researchfish
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Relative survival is used extensively in population-based cancer studies to measure patient survival correcting for causes of death not related to the disease of interest. An advantage of relative survival is that it provides a measure of mortality associated with a particular disease, without the need for information on cause of death. Relative survival provides a measure of net mortality, i.e. the probability of death due to cancer in the absence of other causes. This is a useful measure, but it is also of interest to measure crude mortality, i.e. the probability of death due to cancer in the presence of other causes. A previous approach to estimate the crude probability of death in population-based cancer studies used life table methods, but we show how the estimates can be obtained after fitting a relative survival model. We adopt flexible parametric models for relative survival, which use restricted cubic splines for the baseline cumulative excess hazard and for any time-dependent effects. We illustrate the approach using an example of men diagnosed with prostate cancer in England and Wales showing the differences in net and crude survival for different ages. Copyright (C) 2010 John Wiley & Sons, Ltd.
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